[Acute heart failure and preserved systolic function: can we explain all only by the diastolic dysfunction? A prospective study on 145 patients hospitalized for acute pulmonary edema].
BACKGROUND
Heart failure with conserved systolic function is frequent and attributed to the diastolic dysfunction. The diagnosis of diastolic heart failure requires the association of clinical signs of heart failure, a conserved left ventricular systolic function and a diastolic dysfunction.


OBJECTIVE
To determine the proportion of cases of isolated diastolic heart failure among patients hospitalized for acute pulmonary edema.


METHODS
The left ventricular ejection fraction (LVEF), the diastolic function and levels of NT-proBNP have been assessed at admission of 145 patients hospitalized for acute pulmonary edema.


RESULTS
49% of patients included were older than 80 years (mean age 78.6 + 0.9 years). Among the 83 patients with conserved LVEF, 25% had an ischemic heart disease, 24% a severe valvular disease, 22% an atrial fibrillation, 5% a severe bradycardia, 2% a severe hypertrophic obstructive cardiomyopathy. Only 15 patients presented an isolated diastolic heart failure. The level of NT-proBNP was correlated to LVEF but was not able to identify those with isolated diastolic heart failure in the group with "conserved systolic function".


CONCLUSIONS
Among patients hospitalized for acute pulmonary edema, the prevalence of heart failure with conserved systolic function is high, but only 10% of them presented an isolated diastolic heart failure. The NT-proBNP levels do not permit to identify them.
Barthez
O
O
Unit'e thérapeutique d'insuffisance cardiaque, centre de cardiologie, hôpital du Bocage, CHU de Dijon, Dijon.
Eicher
J C
JC
Saint-Pierre
F
F
Soto
F X
FX
Ressencourt
O
O
Wolf
J E
JE
D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D003971:Diastole / Q000502:physiology*; D006333:Heart Failure / Q000209:etiology / Q000503:physiopathology*; D006352:Heart Ventricles / Q000503:physiopathology; D006439:Hemodynamics; D006801:Humans; D017202:Myocardial Ischemia / Q000150:complications; D011446:Prospective Studies; D011651:Pulmonary Artery / Q000503:physiopathology; D011654:Pulmonary Edema / Q000150:complications* / Q000503:physiopathology; D011667:Pulmonary Veins / Q000503:physiopathology; D012016:Reference Values; D013599:Systole / Q000502:physiology*